Influence of fatigue loading on fracture resistance of endodontically treated teeth restored with endocrowns

Purpose: This in vitro study aimed to evaluate the influence of fatigue loading on fracture resistance of endodontically treated molars restored with endocrowns using different machinable blocks. Methods: Endodontically treated mandibular first molars were prepared using a standardized method. Specimens were divided into 4 groups (n = 10). Anatomically shaped endocrowns groups were manufactured using VITA ENAMIC (VE) and KATANA Zirconia (KZ). Layered endocrowns groups were manufactured using IPS e.max CAD (EM) and BioHPP (BH). Half of the specimens of each group were subjected to fracture resistance test, while the other half were subjected to thermocycling and chewing simulation. After fatigue loading, specimens were loaded until failure. Specimens were examined using stereomicroscopy. Data were analyzed using ANOVA analysis of variance and Bonferroni post hoc test (alpha=0.05). Results: KZ group had the highest initial fracture resistance value (1810.20 +/- 119.56 N) and BH had the lowest value (579.50 +/- 76.15 N). The reduction of fracture resistance after fatigue loading was significant for KZ group (1588.30 +/- 216.25 N) and BH group (502.60 +/- 11.53 N) and non-significant to VE group (1101.70 +/- 77.05 N) and EM group (1112.10 +/- 74.12 N). Failure modes of KZ and EM groups showed high percentage of non-restorable fractures, while VE and BH groups showed high percentage of restorable fractures. Conclusions: Within the limitations of this study, the following can be concluded: Poly infiltrated ceramics should be considered as a proper material to be used as an endocrown material because of its ability to be restorable if failure occurred.